1245408707 NPI number — MISS MELISSA LYNN WINTTURI L. AC.

Table of content: MISS MELISSA LYNN WINTTURI L. AC. (NPI 1245408707)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245408707 NPI number — MISS MELISSA LYNN WINTTURI L. AC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WINTTURI
Provider First Name:
MELISSA
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
L. AC.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245408707
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/20/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
126 INMAN ST
Provider Second Line Business Mailing Address:
SUITE 4
Provider Business Mailing Address City Name:
CAMBRIDGE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02139-1206
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-400-1531
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
126 INMAN ST
Provider Second Line Business Practice Location Address:
SUITE 4
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02139-1206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-400-1531
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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